BACKGROUND: Ultrasound (US)-guided fine needle aspiration cytology (FNAC) is an accurate, reliable, and simple method to identify a thyroid nodule as benign or malignant. However, non-diagnostic cytology results for thyroid nodules are a major limitation of US-guided FNAC. PURPOSE: To investigate the incidence of thyroid cancer among cases with non-diagnostic results on FNAC and to provide suggestions for the management of thyroid nodules that are initially non-diagnostic by FNAC according to ultrasonographic findings. MATERIAL AND METHODS: From July 2006 to December 2009, 10,317 thyroid nodules in 6684 consecutive patients underwent US-guided FNAC at our institute. Among these, 871 thyroid nodules (8.4%) were diagnosed as non-diagnostic on initial cytologic evaluation and 196 underwent a second or third FNAC. Twenty-seven thyroid nodules (18.9%) underwent surgery, while 116 thyroid nodules were cytologically confirmed as benign with no remarkable change on follow-up US were included. We retrospectively reviewed the US findings for a total of 143 thyroid nodules (123 benign nodules and 20 malignant nodules). The US features that we compared included composition, echogenicity, margin, calcifications, shape, and underlying echogenicity. RESULTS: In total, thyroid cancer was diagnosed in 20 nodules (14.0%). The size of the nodule was significantly associated with malignancy (P < 0.05). Most of the sonographically probable benign nodules were found to be benign (97.6%). Suspicious nodules on US were thyroid cancer in 43.2% of cases. Marked hypoechogenicity, microlobulated or irregular margin, microcalcifications, and taller-than-wide shape were significant US findings that correlated with malignancy (P < 0.05). The diagnostic performance of ultrasound for initially non-diagnostic thyroid nodules was as follows: sensitivity of 90.0%, specificity of 65.0%, positive predictive value of 29.5%, and negative predictive value of 97.6%. CONCLUSION: In terms of management of thyroid nodules with non-diagnostic FNAC cytology, US evaluation is a feasible and useful method for predicting malignancy.
BACKGROUND: Ultrasound (US)-guided fine needle aspiration cytology (FNAC) is an accurate, reliable, and simple method to identify a thyroid nodule as benign or malignant. However, non-diagnostic cytology results for thyroid nodules are a major limitation of US-guided FNAC. PURPOSE: To investigate the incidence of thyroid cancer among cases with non-diagnostic results on FNAC and to provide suggestions for the management of thyroid nodules that are initially non-diagnostic by FNAC according to ultrasonographic findings. MATERIAL AND METHODS: From July 2006 to December 2009, 10,317 thyroid nodules in 6684 consecutive patients underwent US-guided FNAC at our institute. Among these, 871 thyroid nodules (8.4%) were diagnosed as non-diagnostic on initial cytologic evaluation and 196 underwent a second or third FNAC. Twenty-seven thyroid nodules (18.9%) underwent surgery, while 116 thyroid nodules were cytologically confirmed as benign with no remarkable change on follow-up US were included. We retrospectively reviewed the US findings for a total of 143 thyroid nodules (123 benign nodules and 20 malignant nodules). The US features that we compared included composition, echogenicity, margin, calcifications, shape, and underlying echogenicity. RESULTS: In total, thyroid cancer was diagnosed in 20 nodules (14.0%). The size of the nodule was significantly associated with malignancy (P < 0.05). Most of the sonographically probable benign nodules were found to be benign (97.6%). Suspicious nodules on US were thyroid cancer in 43.2% of cases. Marked hypoechogenicity, microlobulated or irregular margin, microcalcifications, and taller-than-wide shape were significant US findings that correlated with malignancy (P < 0.05). The diagnostic performance of ultrasound for initially non-diagnostic thyroid nodules was as follows: sensitivity of 90.0%, specificity of 65.0%, positive predictive value of 29.5%, and negative predictive value of 97.6%. CONCLUSION: In terms of management of thyroid nodules with non-diagnostic FNAC cytology, US evaluation is a feasible and useful method for predicting malignancy.
Authors: Miguel Paja; Jose Luis Del Cura; Rosa Zabala; Igone Korta; Aitziber Ugalde; José I López Journal: Eur Radiol Date: 2019-02-19 Impact factor: 5.315
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Authors: Juan P Brito; Michael R Gionfriddo; Alaa Al Nofal; Kasey R Boehmer; Aaron L Leppin; Carl Reading; Matthew Callstrom; Tarig A Elraiyah; Larry J Prokop; Marius N Stan; M Hassan Murad; John C Morris; Victor M Montori Journal: J Clin Endocrinol Metab Date: 2013-11-25 Impact factor: 5.958
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